1. Field of the Invention
The present invention relates to surgical devices and methods for affixing two sections of tissue together, and, more particularly, to a device and method for affixing a piece of soft tissue to a bone or affixing two pieces of bone together.
2. Description of Related Art
Orthopedic surgical procedures sometimes require an attachment (or reattachment) of a flexible member to a bone. The flexible member might comprise soft tissue such as a ligament or tendon, a synthetic element, or suture. Devices and methods are known in the art to accomplish such an attachment, including those for affixing the flexible member within a hole of the bone.
For example, it is known to use a member such as a screw to press at least one end of the flexible member against the interior wall of a bone space (Mahony, U.S. Pat. No. 5,062,843; Roger et al., U.S. Pat. No. 5,383,878; Steininger et al., U.S. Pat. No. 5,425,767; Huebner, U.S. Pat. No. 5,454,811; Laboureau, EU 0 317 406). It is also known to anchor a ligament between two elements, the inner one deformable (U.S. Pat. No. 5,108,431), and to pass a ligament through a center of a device, creating tension by relative movement of elements (DeSatnick, U.S. Pat. No. 5,571,184).
A particular surgery in which flexible member attachment is required is endosteal fixation, wherein the terminal ends with bone plugs of an anterior cruciate ligament graft replacement material are attached within bone tunnels. The attachment is often achieved by compressive or interference fit means.
Other such surgeries include rotator cuff and SLAP lesion repairs.
In addition, it is known to affix two bone sections together, which at present is accomplished with bone screws and/or cabling.
Further, it is known to affix a section of soft tissue to a surface of a bone without the soft tissue proceeding into a bone tunnel (U.S. Pat. No. 4,988,351).
It is an object of the present invention to provide a system and method for affixing a piece of soft tissue to a bone.
It is a further object to provide such a system that has an element for securing the soft tissue piece within a bone tunnel and another element for securing another portion of the soft tissue against the outside the bone tunnel.
It is another object to provide such a system and method that permits repositioning the soft tissue following an initial fixation.
It is an additional object to provide a system and method for affixing two pieces of bone together.
These and other objects are attained with the system and method of the present invention. A particular embodiment of the system is for fixing soft tissue within a bone tunnel and comprises a first fixation member that has a proximal end and a distal end and is adapted for insertion upon a piece a first portion of soft tissue positioned within the bone tunnel. A second portion of the soft tissue is positioned to emerge from the bone tunnel. A second fixation member is adapted to engage the first fixation member at its proximal end. The second fixation member has means for restraining disengagement with the first fixation member and a proximal end, which has means for engaging the soft tissue""s second portion. In an embodiment the first fixation member comprises a screw-type member having a bore extending from the proximal end and the second fixation member has a distal post portion adapted for mating with the bore and driving the screw rotationally thereby.
In a first subembodiment, the second fixation member comprises a tack member and a barbed washer that is rotatable about the post and retainable by a head portion on the tack member. The barbs on the washer are for engaging and restraining a movement of the soft tissue outside the bone tunnel.
In a second subembodiment, the second fixation member comprises a tack-type element that has a barbed head. As above, the barbs are for engaging and restraining the soft tissue outside the bone tunnel.
An alternate embodiment of the invention includes a system for affixing a piece of tissue to a bone, which may comprise affixing soft tissue to bone or two pieces of bone together. This system comprises a generally cylindrical cannula member that is adapted for insertion through the tissue piece and into a tunnel in the bone.
A generally cylindrical screw member is dimensioned for insertion through the cannula member, the screw member having a head at a proximal end and a bore extending at least partially therethrough from the proximal end. The bore has means for being driven by a driver.
A barbed washer has a hole extending from a proximal face through to a distal face. The hole is dimensioned for free rotation about the screw member and for retention by the screw head therebeneath. The distal face has a plurality of barbs extending generally distalward for engaging and retraining a movement of the distal tissue piece.
Yet another embodiment is also for a system for fixing soft tissue within a bone tunnel. The system comprises a first fixation member that has a proximal end and a distal end. The first fixation member is adapted for insertion against a first portion of soft tissue that has been positioned within a bone tunnel, with a second portion of the soft tissue emerging from the bone tunnel.
A second fixation member has means for engaging the first fixation member at its proximal end and also means for preventing the first fixation member""s proximal end from passing into the bone tunnel. The proximal end has means for engaging the soft tissue""s second portion.
Finally, means are engageable with the second fixation member for extracting it from engagement with the soft tissue""s second portion.